title: Selective lateral compartment neck dissection for thyroid cancer.
abstract: BACKGROUND
  Compartment-oriented lymph node dissection in patients with thyroid cancer and macroscopic lymph node metastases reduces recurrence and improves survival. However, the extent of lymph node dissection remains controversial. The purpose of this study was to examine the results of selective lateral compartment neck dissection (LCND) for thyroid cancer.
  
  
  METHODS
  We completed a retrospective review of patients with thyroid cancer who underwent selective LCND from 1992-2012 to determine the extent of lymph node resection, morbidity, recurrence, subsequent operations, mortality, and duration of follow-up.
  
  
  RESULTS
  A total of 45 LCNDs (five bilateral) were performed in 40 patients, 35 with differentiated thyroid cancer (DTC) and five with medullary carcinoma. Nineteen LCNDs (42%) were completed at the time of thyroidectomy. Levels IIA, III, IV, and VB were included in 43 LCNDs (96%) and levels IIA, III, and IV in two LCNDs (4%). Morbidity included neck or ear numbness in 19 patients (48%), neuropathic symptoms in 14 (35%), Horner syndrome in two (5%), marginal mandibular nerve paresis in two (5%), and wound infection in one (3%). Recurrence rate was 25% (10 patients) and one or more reoperations were performed in seven patients (18%) with a mean follow-up of 58 ± 60 mo (range, 1-244 mo). There were 3 ipsilateral recurrences (8%) after 40 LCNDs for DTC. Four patients died from systemic disease: three with medullary carcinoma and one with PTC.
  
  
  CONCLUSIONS
  Selective LCND is an effective therapeutic strategy for macroscopic lymph node metastases, with an 8% recurrence rate in the ipsilateral neck in patients with DTC. Neuropathic symptoms, however, remain an important source of morbidity.
authors.affiliation: Northeast Ohio Medical University, Rootstown, Ohio, USA.
authors.forename: Kellen
authors.initials: K
authors.lastname: Welch
authors.forename: Christopher R
authors.initials: CR
authors.lastname: McHenry
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018276:Carcinoma, Medullary / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000401:mortality / Q000556:secondary / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000033:anatomy & histology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D037981:Neck Dissection / Q000379:methods*; D009334:Neck Muscles / Q000033:anatomy & histology / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D055815:Young Adult
keywords: Selective lateral compartment neck dissection; Thyroid cancer